What important, immediate postoperative care practice should the nurse remember when caring for a woman who has had a mastectomy?

Venipuncture for blood work should be performed on the affected arm.

The blood pressure (BP) cuff should not be applied to the affected arm.

The affected arm should be held down close to the woman's side.

The affected arm should be used for intravenous (IV) therapy.

Answer and Explanation

The Correct Answer is B

Choice A reason: This is incorrect because venipuncture for blood work should be avoided on the affected arm. The mastectomy may have involved the removal of lymph nodes, which can impair the lymphatic drainage and increase the risk of lymphedema (swelling) in the arm. Venipuncture can cause further damage or infection to the arm.

Choice B reason: This is correct because the BP cuff should not be applied to the affected arm. The BP cuff can exert pressure on the arm and interfere with the blood and lymph flow. This can also increase the risk of lymphedema or pain in the arm.

Choice C reason: This is incorrect because the affected arm should not be held down close to the woman's side. The woman should be encouraged to elevate the arm above the level of the heart and perform gentle exercises to promote circulation and prevent stiffness. The arm should not be immobilized or restricted.

Choice D reason: This is incorrect because the affected arm should not be used for IV therapy. IV therapy can introduce fluids or medications into the arm that can affect the blood and lymph flow. It can also cause irritation or infection to the arm.

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Correct Answer is C

Explanation

Choice A reason: Anxiety due to hospitalization is not a likely cause of the signs reported by the patient. Anxiety can cause some symptoms, such as headache, palpitations, or sweating, but it does not cause visual changes or epigastric pain. Anxiety is also not a common complication of pregnancy-induced hypertension, which is a condition characterized by high blood pressure and protein in the urine.

Choice B reason: Effects of magnesium sulfate are not a likely cause of the signs reported by the patient. Magnesium sulfate is a medication used to prevent seizures and lower blood pressure in patients with pregnancy-induced hypertension. It can cause some side effects, such as flushing, nausea, or drowsiness, but it does not cause headache, visual changes, or epigastric pain. In fact, magnesium sulfate can help relieve these symptoms by reducing the cerebral edema and vasospasm caused by pregnancy-induced hypertension.

Choice C reason: Worsening disease and impending convulsion are the most likely cause of the signs reported by the patient. These signs indicate that the patient is developing severe preeclampsia or eclampsia, which are life-threatening complications of pregnancy-induced hypertension. Preeclampsia is characterized by high blood pressure, protein in the urine, and signs of organ damage, such as headache, visual changes, epigastric pain, or decreased urine output. Eclampsia is the occurrence of seizures in a patient with preeclampsia. These conditions can lead to stroke, bleeding, placental abruption, or fetal distress, and require immediate medical attention.

Choice D reason: Gastrointestinal upset is not a likely cause of the signs reported by the patient. Gastrointestinal upset can cause some symptoms, such as nausea, vomiting, or abdominal pain, but it does not cause headache, visual changes, or epigastric pain. Gastrointestinal upset is also not a common complication of pregnancy-induced hypertension, which is a condition that affects the blood vessels and organs, not the digestive system.

A. cramping. B. uterine activity. C. bleeding. D. intense abdominal pain.

Correct Answer is D

Explanation

Choice A reason: Cramping is a common symptom of pregnancy, especially in the third trimester, due to the stretching of the ligaments and muscles that support the uterus. It is not a specific sign of abruptio placentae, which is the premature separation of the placenta from the uterine wall.

Choice B reason: Uterine activity is a normal phenomenon of pregnancy, as the uterus contracts and relaxes periodically. It is not a specific sign of abruptio placentae, which is associated with increased uterine tone and tenderness.

Choice C reason: Bleeding is a possible sign of both abruptio placentae and placenta previa, which is the implantation of the placenta over or near the cervical os. However, bleeding is more common and severe in placenta previa than in abruptio placentae, as the latter can have concealed hemorrhage.

Choice D reason: Intense abdominal pain is the most prevalent clinical manifestation of abruptio placentae, as the blood accumulates behind the placenta and causes pressure and irritation of the uterine nerves. It is a distinguishing sign from placenta previa, which is usually painless.

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What important, immediate postoperative care practice should the nurse remember when caring for a woman who has had a mastectomy?

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Naxlex Comprehensive Predictor Exams

A patient with pregnancy-induced hypertension is admitted complaining of pounding headache, visual changes, and epigastric pain. Nursing care is based on the knowledge that these signs are an indication of:

Correct Answer is C

Explanation

The most prevalent clinical manifestation of abruptio placentae (as opposed to placenta previa) is:

Correct Answer is D

Explanation

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